Corporate report

UKHSA Advisory Board: Equalities, Ethics and Communities Committe minutes

Updated 11 September 2025

1. Recommendation

The Advisory Board is asked to note the minutes of 8 April 2025 meeting of the Equalities, Ethics and Communities Committee. The minutes were agreed on 15 July 2025.

2. Minutes (confirmed), UKHSA Equalities, Ethics and Communities Committee, 8 April 2025

Present at the meeting were:

• Graham Hart – Non-Executive Member of UKHSA Advisory Board (Chair)
• Shona Arora – Director, Health Equity and Clinical Governance
• Dame Marie Gabriel – Associate non-executive member
• Mark Lloyd – Non-Executive Member of UKHSA Advisory Board
• Hannah Taylor – Director, Policy
• Will Welfare – Director, Health Protection in Regions
• 1 member had their name and title redacted

In attendance were:

• 10 attendees had their names and titles redacted

Apologies:

• Olly Clifton-Moore - Director, Analysis & Intelligence Assessment
• Susan Hopkins – Chief Medical Advisor (Executive Lead)
• Raj Long – Associate Non-Executive Member of UKHSA Advisory Board

3. Welcome, apologies and declarations of interest

25/023 The Chair welcomed participants to the meeting, noted apologies, and confirmed that there were no declarations of interest.

4. Minutes of the previous meeting and actions

25/024 The Equalities, Ethics and Communities Committee agreed the minutes of the 8 October 2024 meeting (enclosure EEC/25/008) and noted the action log (enclosure EEC/25/009).

25/025 The Terms of Reference were agreed subject to the removal of line 3.1c) to reflect the current priority governance fora for collaboration.

25/026 Verbal updates were provided on:

• Government priorities – the Committee noted verbal updates on the closure of NHS England, the government wide arms-length body review and Spending Review submissions. UKHSA teams were preparing rapid responses to highlight the unique contribution the agency made to public health, clarity on the capability needed to delivery its remit, and risks/opportunities arising from the changes.

• Conference reflections – the Committee welcomed the focus on health equity at the latest UKHSA Conference. Specific reflections noted the positive engagement from industry showcasing at the conference; post-event engagement from partners wanting to continue collaboration to address health inequalities; and cross-organisation discussions with a particular focus on data opportunities.

5. Health and Justice Update

25/027 [Title redacted] presented the update on UKHSA’s Health and Justice related activity (enclosure EEC/25/011). System leadership for Health and Justice activity in the previous 2 years included:

• UKHSA leading authorship of the draft health protection chapter in Chief Medical Officer’s report on health in prisons and probation. The 6 themes identified would inform the future work programme to have the greatest impact on populations and associated inequalities;
• a bespoke prison radio communication campaign;
• continuing evidence generation to inform guidance; and
• reactive incident response including cases of Covid-19 tuberculosis and several complex measles incidents.

25/028 The Committee noted the progress, ambition and scope to address health security in Health and Justice populations. Priorities over the next year included a focus on those working in prisons and places of detention (alongside prisoner health), and renewal of national partnership agreements.

25/029 Mark Lloyd noted his position as a non-executive director as HM Prison and Probation Service (HMPPS) ahead of discussion.

25/030 The following points were raised during discussion:

• UKHSA should engage wider government meaningfully through data. Mark Lloyd offered to support engagement between HMPPS and UKHSA colleagues, noting recent leadership changes at HMPPS and the Ministry of Justice [Action: Mark Lloyd and [Name redacted])
• focusing on engagement with partners who were critical to achieving intended outcomes
• local assurance and accountability could support monitoring of individuals at community level as they progressed through the system. These challenges may increase with upcoming findings from the Gauke Independent Sentencing Review
• the impacts of affected populations needed to be clear to external audiences;
• strengthening evidence on environmental threats in prisons and place of detention would support it as a priority area with partners
• it could be worthwhile connecting with work undertaken through Health Protection Research Units

25/031 The Committee welcome a general update at a future meeting on ethics in prisons and places of detention, including duty of care to the individual alongside communities.

6. Antimicrobial resistance (AMR) and health inequalities

25/032 [Titles redacted] presented the update on antimicrobial resistance (enclosure EEC/25/012). There was increasing knowledge and data on how antibiotic usage and resistance levels differ in populations. Data demonstrated higher rates of antibiotic use in most deprived populations and increasing differences in the burden and rates of resistant bloodstream infections by ethnicity and social deprivation respectively.

25/033 The National Action Plan included 3 main commitments related to health inequalities. These covered improving reporting, toolkits to adapt resources for local needs and delivering targeted interventions.

25/034 The Committee noted the progress made toward National Action Plan commitments for health inequalities and disparities.

25/035 The discussion noted:

• advice on antibiotic usage was targeted to medical professionals (for example, ESPAUR Report) and patients. Recent public campaigns included Andi Biotic and engagement with faith in action groups to target disproportionately affected groups
• clarity on argument and cost effectiveness would increase support for a targeted approach
• we are on track for commitment 8.1 to establish pathways for annual reporting on infection incidence, AMR and antimicrobial use. These will be reported in the  annual report for England (ESPAUR) and discussions continue with devolved administrations to work toward consistent reporting across nations
• an outcome driven approach over process would support development of an agreed target

25/036 It was agreed to provide a further update to the Committee when the evidence base was expanded to support interventions. (Action: [Name redacted])

7. Ethics approaches in UKHSA

25/037 [Title redacted] presented an update on ethics approaches in clinical and public health services (enclosure EEC/25/013).

25/038 UKHSA aimed to establish a consistent approach to ethics decisions that would support defensible decision making, maintain public trust in actions and support staff navigating ethical decisions. The agency had compared comparable institutions alongside the types of ethical challenges agency staff face. While select examples existed of exemplary practice, sharing of learning was limited and no nominated source of help existed. Conclusions indicated the need for a proportionate response with a ladder of interventions to support ethical decision making through:

• professional practice codes
• an ethics toolkit which refined through staff engagement over the coming 6 months
• convening an ethics panel.

25/039 The Equalities, Ethics and Communities Committee noted the range of ethics concerns that UKHSA may face and the methods used by other relevant comparator organisations to address these. 

25/040 The Committee provided the following feedback:

• there was support for road-testing the length of ethics toolkit to ensure staff had time to address all questions. It was noted that teams using the ethics toolkit would have exhausted other advice through professional practice codes
• the tools should recognise the ethics of working with communities with the [Title redacted] offering support in this area (Action: [Name redacted])
• it may be helpful to recognise informal ethical advice before convening an ethics panel which could be added as an additional ladder rung

25/041 The Committee welcomed an update at appropriate time to show how the ladder of interventions worked in practice and the demand for an ethics panel. (Action: Shoan Arora / [Name redacted])

8. Forward look and topics for future meetings

25/042 The Equalities, Ethics and Communities Committee noted the Forward Look (enclosure EEC/25/014).

25/043 It was agreed to continue verbal updates at the beginning of each meeting on health sector changes and government.

9. Any other business and close

25/044 The Committee noted the exceptions report from the Health Equity Board which ensured oversight of equity work across the organisation (enclosure EEC/25/015).

25/045 The Committee were invited to share reflections in correspondence to feed into the Health Equity Update at the July Advisory Board.

25/046 The meeting closed at 3:39pm.